Treating Self-Injury - Treatment for Self-Injury

Written by HealthyPlace.com Staff Writer

motochik78: How can those with dissociative disorders work on ending self injury that is done while in a dissociative state, especially when the "alter" that is "out" enjoys the self injury so much that they purposefully hurt the person, that they can't overcome it?

Michelle Seliner: This is a difficult question. As you may know there is controversy surrounding the diagnosis of DID. When we encounter someone who comes to us with a DID diagnosis we first work on grounding techniques, in hopes to prevent the "alters" from taking over. We treat dissociation the same way we do self-injury, in that we see it as an a coping strategy to avoid uncomfortable feeling states. We ask clients to pay attention to their dissociation and to pair it with feeling states. If someone is DID, and can't sign our No-Harm contract, it may be that they need to do some more individual and integrative work before they would be ready for our program.

mousey!!: If a person enjoys self-injury, like doing it, I don't know, because it feels good, is there any way to get them to agree to get help?

Michelle Seliner: You can offer them support and information. Self-injury does serve a soothing purpose for someone who is struggling. Bodily Harm is a good resource for persons who self-injure, their families and professionals.

KrazyKelz89: What is the relapse rate of someone who self-injures and stops?

Michelle Seliner: We have found that post-treatment in the SAFE program that 75% of clients are self-injury free 2 years post-treatment. I cannot speak for the general population, as many self-injurers, prior to treatment, start and stop injuring. Typically a psychiatrist is used to manage medication for an accompanying diagnosis.

Psychiatrists usually do not do psychotherapy. Some clients have found a support group to be helpful.

Natalie: Michelle, do you think more people are self-injuring because it's glorified on tv or other media?

Michelle Seliner: Certainly that is a contributing factor but there are also others. It is a common coping strategy used by those struggling. We do not subscribe to the contagion effect, as healthy people do not self-injure.

miked123lf: What about the PEM program, the Psycho-Educational Model program where rewards are given for positive behavior? Could that work for cutters and people who self-injure? Or is this used for behavioral problems only?

Michelle Seliner: I am not familiar with this program being used for self-injurers. Applying what I know about self-injury, it is so important to remember that self-injury is a choice. Regardless of the rewards or who is asking you to give up the behavior, ultimately it is only you that can keep yourself safe.

Natalie: What are the characteristics of someone who is likely to be more successful when it comes to achieving a positive outcome from treatment?

Michelle Seliner: We have found it very difficult to predict who will do well. However, clients who seem to do best are those that honestly engage in the treatment process and recognize that treatment is for their own well-being and not for the treatment staff or parents.

Natalie: Is there an age limit to get into the SAFE program?

Michelle Seliner: We accept clients 12 and up. To date, our most senior client was 77 years old.

thelostone: Can the S.A.F.E program also help someone my age (43) recover from years of self-harm and not dealing with my feelings for years?

Michelle Seliner: Yes, often times we are a client's last resort. Some of our clients have been hospitalized hundreds of times. For some, it is their first hospitalization.

Natalie: I'm assuming since there are very few self-injury treatment programs, your program is very busy. How long does it take to get in? Is there a wait list?

Michelle Seliner: Yes, there is a waiting list. It can take 2 weeks to 1 month.

NobodyKnows: How would somebody go about seeking admission to the program?

Michelle Seliner: To seek admission to the program, please contact us through the website or call 1.800 DONTCUT (1-800-366-8288).

Natalie: Is there a group of people who self-injure who are treatment-resistant; who despite trying various methods of treatment won't be able to control their behavior?

Michelle Seliner: Unless there is significant neurological damage, we don't believe that people can't control learning to stop self-injury. As stated before, some clients will continue to deal with disorders such as depression, anxiety, thought disorders, bipolar etc. They may still experience intensive emotional states, but they can learn to respond in a healthier, more productive way.

Natalie: We also have parents of children who self-injure, along with family members and loved ones, in the audience tonight. For these individuals, discovering and seeing that someone they care about is hurting themselves it can be very scary, alarming, distressing. What would you say to these people? And what can they do to help the self-injurer?

Michelle Seliner: The first thing to recognize is that they are not "crazy." They are instead trying to cope and survive in the best way they know how. The good news is that people can and do get better all the time and go on to live healthy, happy and productive lives. It is important for family to take the behavior seriously, but anger and hysterics are counter-productive.

It's important to keep the lines of communication open. Parents and friends should not be the therapist, it is helpful for self-injurers to have someone to talk to who can truly help them to identify the problem and learn healthier ways of responding.

Natalie: Our time is up tonight. Thank you, Michelle, for being our guest, for sharing this valuable information on self-injury treatment and for answering audience questions. We appreciate you being here.

Michelle Seliner: Again, thank you for the opportunity to share our approach to treatment of self-injury.

Natalie: I encourage everyone to sign up for our newsletter. It's free and we'll notify you of events happening on our website, and you can sign up for the first and only social network for people with mental health conditions as well as their family members and friends.

Thank you everybody for coming. I hope you found the chat interesting and helpful.

Good night everyone.

Disclaimer: We are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.

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